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Organization

HAVEN MEDICAL GROUP INC.

Active
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Organization

HAVEN MEDICAL GROUP INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JUSTICE OTCHERE MD (MEDICAL DIRECTOR)
(682) 433-9287
Entity
Organization

Contact information

Practice address
1332 W HERNDON AVE STE 101, FRESNO, CA 93711-7118
(682) 433-9287
Mailing address
1332 W HERNDON AVE STE 101, FRESNO, CA 93711-7118
(682) 433-9287

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—

Other

Enumeration date
08/27/2021
Last updated
08/27/2021
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